862: Feasibility Trial of Adaptive Electronic Learning for Pediatric Healthcare Workers in Tanzania

Smith, Zachary; Hokororo, Adolfine; Masenge, Theopista; Mwanga, Joseph R.; Kalabamu, Salvatory; Berg, Marc D.; Rozenfeld, Boris; Xwatsal, Elias; Pastory, Noel; Msoke, Idi; Ndosi, Hanston; Chami, Neema; Mkopi, Namala; Mwanga, Castory; Agweyu, Ambrose; Meaney, Peter A

doi:10.1097/01.ccm.0000909176.92502.dc

Cited by 3 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our initial pilot demonstrated a 30% change in conscious competence during initial learning from 66% (57%–75%) to 94% (92%–98%) 49. The average initial learning completion was only 37% and refresher assignment completion was not assessed.…”

Section: Introductionmentioning

confidence: 85%

“…Our initial pilot demonstrated a 30% change in conscious competence during initial learning from 66% (57%–75%) to 94% (92%–98%). 49 The average initial learning completion was only 37% and refresher assignment completion was not assessed. There were four barriers identified to initial learning completion: (1) use of pre–post assessments for efficacy, (2) lack of in-person technical support, (3) ineffective email nudging strategy, and (4) we observed a significant drop off with disability and exposure assessment using a structured order of modules.…”

Section: Introductionmentioning

confidence: 99%

“…There were four barriers identified to initial learning completion: (1) use of pre–post assessments for efficacy, (2) lack of in-person technical support, (3) ineffective email nudging strategy, and (4) we observed a significant drop off with disability and exposure assessment using a structured order of modules. 49 Based on these results, we revised our implementation strategy in four ways: (1) use of change in conscious competence from baseline for efficacy, (2) a full time in-person programme manager to provide support PACE providers, (3) incorporation of an escalating nudge strategy that included emails, WhatsApp messaging and in-person support, and (4) in addition, we allowed providers to complete modules in any order.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains

Meaney,

Hokororo,

Ndosi

et al. 2024

BMJ Open

Self Cite

View full text Add to dashboard Cite

IntroductionTo improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment. The objectives of this study were to (1) assess implementation success with use of in-person support and nudging strategy and (2) describe baseline provider knowledge and metacognition.Methods6-month observational study at one zonal hospital and three health centres in Mwanza, Tanzania. To assess implementation success, we used the Reach, Efficacy, Adoption, Implementation and Maintenance framework and to describe baseline provider knowledge and metacognition we used Howell’s conscious-competence model. Additionally, we explored provider characteristics associated with initial learning completion or persistent activity.ResultsaESNC reached 85% (195/231) of providers: 75 medical, 53 nursing and 21 clinical officers; 110 (56%) were at the zonal hospital and 85 (44%) at health centres. Median clinical experience was 4 years (IQR 1–9) and 45 (23%) had previous in-service training for both newborn essential and sick newborn care. Efficacy was 42% (SD ±17%). Providers averaged 78% (SD ±31%) completion of initial learning and 7% (SD ±11%) of refresher assignments. 130 (67%) providers had ≥1 episode of inactivity >30 day, no episodes were due to lack of internet access. Baseline conscious-competence was 53% (IQR: 38%–63%), unconscious-incompetence 32% (IQR: 23%–42%), conscious-incompetence 7% (IQR: 2%–15%), and unconscious-competence 2% (IQR: 0%–3%). Higher baseline conscious-competence (OR 31.6 (95% CI 5.8 to 183.5)) and being a nursing officer (aOR: 5.6 (95% CI 1.8 to 18.1)), compared with medical officer, were associated with initial learning completion or persistent activity.ConclusionaESNC reach was high in a population of frontline providers across diverse levels of care in Tanzania. Use of in-person support and nudging increased reach, initial learning and refresher assignment completion, but refresher assignment completion remains low. Providers were often unaware of knowledge gaps, and lower baseline knowledge may decrease initial learning completion or activity. Further study to identify barriers to adaptive e-learning normalisation is needed.

show abstract

Section: Introductionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains

Meaney,

Hokororo,

Ndosi

et al. 2024

BMJ Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…34 – 36 Eighty-five percent of Tanzania's population is covered with at least a 3G network and 14% of the population has active mobile broadband subscribers. 37 In our initial feasibility studies, all 21 medical and clinical officer interns had smartphones with data plans, and 19 reported a preference to use their mobile phones for e-learning over tablets or computers. 38 , 39 Course delivery of AEEs encourages scalability .…”

mentioning

confidence: 99%

“… 37 In our initial feasibility studies, all 21 medical and clinical officer interns had smartphones with data plans, and 19 reported a preference to use their mobile phones for e-learning over tablets or computers. 38 , 39 Course delivery of AEEs encourages scalability . While course development costs are fixed, course delivery costs are minimal compared to conventional education.…”

mentioning

confidence: 99%

Development of pediatric acute care education (PACE): An adaptive electronic learning (e-learning) environment for healthcare providers in Tanzania

Meaney

Hokororo

Masenge³

et al. 2023

DIGITAL HEALTH

View full text Add to dashboard Cite

Globally, inadequate healthcare provider (HCP) proficiency with evidence-based guidelines contributes to millions of newborn, infant, and child deaths each year. HCP guideline proficiency would improve patient outcomes. Conventional (in person) HCP in-service education is limited in 4 ways: reach, scalability, adaptability, and the ability to contextualize. Adaptive e-learning environments (AEE), a subdomain of e-learning, incorporate artificial intelligence technology to create a unique cognitive model of each HCP to improve education effectiveness. AEEs that use existing internet access and personal mobile devices may overcome limits of conventional education. This paper provides an overview of the development of our AEE HCP in-service education, Pediatric Acute Care Education (PACE). PACE uses an innovative approach to address HCPs’ proficiency in evidence-based guidelines for care of newborns, infants, and children. PACE is novel in 2 ways: 1) its patient-centric approach using clinical audit data or frontline provider input to determine content and 2) its ability to incorporate refresher learning over time to solidify knowledge gains. We describe PACE's integration into the Pediatric Association of Tanzania's (PAT) Clinical Learning Network (CLN), a multifaceted intervention to improve facility-based care along a single referral chain. Using principles of co-design, stakeholder meetings modified PACE's characteristics and optimized integration with CLN. We plan to use three-phase, mixed-methods, implementation process. Phase I will examine the feasibility of PACE and refine its components and protocol. Lessons gained from this initial phase will guide the design of Phase II proof of concept studies which will generate insights into the appropriate empirical framework for (Phase III) implementation at scale to examine effectiveness.

show abstract

Feasibility of an Adaptive E-Learning Environment to Improve Provider Proficiency in Essential and Sick Newborn Care in Mwanza, Tanzania

Meaney,

Hokororo,

Ndosi

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction.To improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment (AEE). The objectives of this study were to 1) assess implementation success with use of in-person support and nudging strategy and 2) describe baseline provider knowledge and metacognition.Methods.6-month observational study at 1 zonal hospital and 3 health centers in Mwanza, Tanzania. To assess implementation success, we used the RE-AIM framework and to describe baseline provider knowledge and metacognition we used Howell's conscious-competence model. Additionally, we explored provider characteristics associated with initial learning completion or persistent activity.Results.aESNC reached 85% (195/231) of providers: 75 medical, 53 nursing, and 21 clinical officers; 110 (56%) were at the zonal hospital and 85 (44%) at health centers. Median clinical experience was 4 years [IQR 1,9] and 45 (23%) had previous in-service training for both newborn essential and sick newborn care. Efficacy was 42% (SD+/-17%). Providers averaged 78% (SD+/-31%) completion of initial learning and 7%(SD+/-11%) of refresher assignments. 130 (67%) providers had >1 episode of inactivity >30 day, no episodes were due to lack of internet access. Baseline conscious-competence was 53% [IQR:38-63%], unconscious-incompetence 32% [IQR:23-42%], conscious-incompetence 7% [IQR:2-15%], and unconscious-competence 2% [IQR:0-3%]. Higher baseline conscious-competence (OR 31.6 [95%CI:5.8, 183.5) and being a nursing officer (aOR: 5.6 [95%CI:1.8, 18.1]), compared to medical officer) were associated with initial learning completion or persistent activity.Conclusion.aESNC reach was high in a population of frontline providers across diverse levels of care in Tanzania. Use of in-person support and nudging increased reach, initial learning, and refresher assignment completion, but refresher assignment completion remains low. Providers were often unaware of knowledge gaps, and lower baseline knowledge may decrease initial learning completion or activity. Further study to identify barriers to adaptive e-learning normalization is needed.

show abstract

862: Feasibility Trial of Adaptive Electronic Learning for Pediatric Healthcare Workers in Tanzania

Cited by 3 publications

References 0 publications

Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains

Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains

Development of pediatric acute care education (PACE): An adaptive electronic learning (e-learning) environment for healthcare providers in Tanzania

Feasibility of an Adaptive E-Learning Environment to Improve Provider Proficiency in Essential and Sick Newborn Care in Mwanza, Tanzania

Contact Info

Product

Resources

About